According to the Department of Health, thyroid cancer ranks 7th overall in cancer cases in the Philippines. It ranks 4th in cancer cases among females and 17th in males. The incidence is three times more in females than that in males. Thyroid cancer is the most common cancer of women at ages 15-24.
The thyroid gland is shaped like a butterfly located in the neck in front and beside the trachea or better known as the airway or windpipe. The main function of the gland is to control the metabolic rate of the body in producing energy from nutrients producing the hormones triiodothyronine (T3) and thyroxine (T4) using iodine from your diet. Thyroid hormones are released as a response from the hormone TSH or thyroid stimulating hormone which is secreted by the pituitary gland. Thyroid diseases happen when there is an imbalance of these hormones caused by an overactive thyroid, iodine deficiency, or autoimmune diseases. Awareness about the thyroid and its functions, as well as thyroid diseases and recognizing its symptoms is important in knowing when you need to see your doctor.
Hypothyroidism is a condition when there is a decrease in thyroid hormones, symptoms of which include fatigue, weakness, weight gain, and cold intolerance. This is because the body does not have enough thyroid hormones to utilize in aiding in the body’s metabolism.
Your doctor will diagnose hypothyroidism by measuring the TSH levels. When the body’s T3 and T4 levels are low, the response of the body is to make more thyroid hormones with the pituitary gland releasing more TSH. Hence, the TSH levels in persons with hypothyroidism will be elevated. This condition is treated with thyroid hormone replacement, levothyroxine. This is the drug of choice in treating hypothyroidism, with the dosage being based on your weight and adjusted accordingly as you respond to treatment.
In developed countries, the most common cause of hypothyroidism is Hashimoto’s disease. It is an autoimmune disorder causing chronic inflammation and subsequent failure of the thyroid gland, thus the thyroid gland can no longer produce thyroid hormones. In developing countries, however, the most common cause of hypothyroidism is iodine deficiency. Since iodine is needed in the production of thyroid hormones, the thyroid cannot produce thyroid hormone when iodine is deficient thus causing hypothyroidism.
Hyperthyroidism on the other hand is the opposite of hypothyroidism since this is a condition when the thyroid gland is overactive. Symptoms would include unintentional weight loss, palpitations, increased appetite, nervousness, sweating, and more frequent bowel movements. These symptoms are a consequence of an increased rate of metabolism due to increased thyroid hormones. The most common cause of hyperthyroidism is Grave’s disease which is an autoimmune disorder causing antibodies to stimulate the thyroid gland to produce more thyroid hormones. Other causes of hyperthyroidism include excess iodine in the diet and inflammation of the thyroid glands.
Thyroid disorders can also present as an anterior neck mass. Warning signals for thyroid cancer include a hard mass in the anterior neck; nodules of the thyroid in men, rapid enlargement of a long-standing goiter in older patients, cervical lymph node enlargement, hoarseness, the difficulty of swallowing, and difficulty of breathing associated with goiter. Majority of thyroid cancers in the Philippines are well-differentiated carcinoma. This type is highly curable by appropriate surgery alone. However, in cases of metastasis, radioactive iodine is the main mode of treatment.
Radioimmunoassay or RIA test is the most reliable test for thyroid gland function for thyroid disorders and is offered at the Nuclear Medicine Center of SUMC. According to Dr. Proceso Marc F. Udarbe, Director of Special Clinical Services of the Hospital, the Center treats thyroid disorders with radioactive iodine treatment in the form of a capsule taken orally, as primary treatment for hyperthyroidism, simple goiter, and thyroid cancer.
Thyroid diseases may seem intimidating to most of us. However, thyroid diseases like hypothyroidism and hyperthyroidism are manageable. When you consult your doctor and get the right diagnosis and treatment, your health and quality of life will improve with the right treatment.
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Caesey Mae Yurong and April Anne Joyce Mugas are 4th-year junior interns of the Department of Surgery at SUMCFI
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